Surgery versus radiofrequency ablation in patients with Child- Pugh class-A/single small (≤3 cm) hepatocellular carcinoma
Background/Aims We compared the post-treatment overall survival (OS) and recurrence-free survival (RFS) between patients with Child-Turcotte-Pugh (CTP) class-A and single small (≤3 cm) hepatocellular carcinoma (HCC) treated by surgical resection (SR) and radiofrequency ablation (RFA). Methods We ret...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Association for the Study of the Liver
2022-04-01
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| Series: | Clinical and Molecular Hepatology |
| Subjects: | |
| Online Access: | http://e-cmh.org/upload/pdf/cmh-2021-0294.pdf |
| _version_ | 1811329832469921792 |
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| author | Jungnam Lee Young-Joo Jin Seung Kak Shin Jung Hyun Kwon Sang Gyune Kim Young Ju Suh Yujin Jeong Jung Hwan Yu Jin-Woo Lee Oh Sang Kwon Soon Woo Nahm Young Seok Kim |
| author_facet | Jungnam Lee Young-Joo Jin Seung Kak Shin Jung Hyun Kwon Sang Gyune Kim Young Ju Suh Yujin Jeong Jung Hwan Yu Jin-Woo Lee Oh Sang Kwon Soon Woo Nahm Young Seok Kim |
| author_sort | Jungnam Lee |
| collection | DOAJ |
| description | Background/Aims We compared the post-treatment overall survival (OS) and recurrence-free survival (RFS) between patients with Child-Turcotte-Pugh (CTP) class-A and single small (≤3 cm) hepatocellular carcinoma (HCC) treated by surgical resection (SR) and radiofrequency ablation (RFA). Methods We retrospectively analyzed 391 HCC patients with CTP class-A who underwent SR (n=232) or RFA (n=159) as first-line therapy for single small (≤3 cm) HCC. Survival was compared according to the tumor size (≤2 cm/2–3 cm) and the presence of cirrhosis. Inverse probability of treatment weighting (IPW) method was used to estimate the average causal effect of treatment. Results The median follow-up period was 64.8 months (interquartile range, 0.1–162.6). After IPW, the estimated OS was similar in the SR and RFA groups (P=0.215), and even in patients with HCC of ≤2 cm (P=0.816) and without cirrhosis (P=0.195). The estimated RFS was better in the SR group than in the RFA groups (P=0.005), also in patients without cirrhosis (P<0.001), but not in those with HCC of ≤2 cm (P=0.234). The weighted Cox proportional hazards model with IPW provided adjusted hazard ratios (95% confidence interval) for OS, and the RFS after RFA versus SR were 0.698 (0.396–1.232) (P=0.215) and 1.698 (1.777–2.448) (P=0.005), respectively. Conclusions SR was similar for OS compared to RFA, but was better for RFS in patients with CTP class-A and single small (≤3 cm) HCC. The RFS was determined by the presence or absence of cirrhosis. Hence, SR rather than RFA should be considered in patients without cirrhosis to prolong the RFS, although there is no OS difference. |
| first_indexed | 2024-04-13T15:50:53Z |
| format | Article |
| id | doaj.art-68e9de90b19d41c7b688ff09e7f3a6d8 |
| institution | Directory Open Access Journal |
| issn | 2287-2728 2287-285X |
| language | English |
| last_indexed | 2024-04-13T15:50:53Z |
| publishDate | 2022-04-01 |
| publisher | Korean Association for the Study of the Liver |
| record_format | Article |
| series | Clinical and Molecular Hepatology |
| spelling | doaj.art-68e9de90b19d41c7b688ff09e7f3a6d82022-12-22T02:40:51ZengKorean Association for the Study of the LiverClinical and Molecular Hepatology2287-27282287-285X2022-04-0128220721810.3350/cmh.2021.02941646Surgery versus radiofrequency ablation in patients with Child- Pugh class-A/single small (≤3 cm) hepatocellular carcinomaJungnam Lee0Young-Joo Jin1Seung Kak Shin2Jung Hyun Kwon3Sang Gyune Kim4Young Ju Suh5Yujin Jeong6Jung Hwan Yu7Jin-Woo Lee8Oh Sang Kwon9Soon Woo Nahm10Young Seok Kim11 Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea Department of Internal Medicine, The Catholic University of Korea Incheon St. Mary’s Hospital, Incheon, Korea Department of Internal Medicine, Soonchunhyang University Hospital Bucheon, Bucheon, Korea Department of Biomedical Sciences, Inha University School of Medicine, Incheon, Korea Department of Biostatistics, Korea University College of Medicine, Seoul, Korea Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea Department of Internal Medicine, The Catholic University of Korea Incheon St. Mary’s Hospital, Incheon, Korea Department of Internal Medicine, Soonchunhyang University Hospital Bucheon, Bucheon, KoreaBackground/Aims We compared the post-treatment overall survival (OS) and recurrence-free survival (RFS) between patients with Child-Turcotte-Pugh (CTP) class-A and single small (≤3 cm) hepatocellular carcinoma (HCC) treated by surgical resection (SR) and radiofrequency ablation (RFA). Methods We retrospectively analyzed 391 HCC patients with CTP class-A who underwent SR (n=232) or RFA (n=159) as first-line therapy for single small (≤3 cm) HCC. Survival was compared according to the tumor size (≤2 cm/2–3 cm) and the presence of cirrhosis. Inverse probability of treatment weighting (IPW) method was used to estimate the average causal effect of treatment. Results The median follow-up period was 64.8 months (interquartile range, 0.1–162.6). After IPW, the estimated OS was similar in the SR and RFA groups (P=0.215), and even in patients with HCC of ≤2 cm (P=0.816) and without cirrhosis (P=0.195). The estimated RFS was better in the SR group than in the RFA groups (P=0.005), also in patients without cirrhosis (P<0.001), but not in those with HCC of ≤2 cm (P=0.234). The weighted Cox proportional hazards model with IPW provided adjusted hazard ratios (95% confidence interval) for OS, and the RFS after RFA versus SR were 0.698 (0.396–1.232) (P=0.215) and 1.698 (1.777–2.448) (P=0.005), respectively. Conclusions SR was similar for OS compared to RFA, but was better for RFS in patients with CTP class-A and single small (≤3 cm) HCC. The RFS was determined by the presence or absence of cirrhosis. Hence, SR rather than RFA should be considered in patients without cirrhosis to prolong the RFS, although there is no OS difference.http://e-cmh.org/upload/pdf/cmh-2021-0294.pdfhepatocellular carcinomaoperationradiofrequency ablationsurvival |
| spellingShingle | Jungnam Lee Young-Joo Jin Seung Kak Shin Jung Hyun Kwon Sang Gyune Kim Young Ju Suh Yujin Jeong Jung Hwan Yu Jin-Woo Lee Oh Sang Kwon Soon Woo Nahm Young Seok Kim Surgery versus radiofrequency ablation in patients with Child- Pugh class-A/single small (≤3 cm) hepatocellular carcinoma Clinical and Molecular Hepatology hepatocellular carcinoma operation radiofrequency ablation survival |
| title | Surgery versus radiofrequency ablation in patients with Child- Pugh class-A/single small (≤3 cm) hepatocellular carcinoma |
| title_full | Surgery versus radiofrequency ablation in patients with Child- Pugh class-A/single small (≤3 cm) hepatocellular carcinoma |
| title_fullStr | Surgery versus radiofrequency ablation in patients with Child- Pugh class-A/single small (≤3 cm) hepatocellular carcinoma |
| title_full_unstemmed | Surgery versus radiofrequency ablation in patients with Child- Pugh class-A/single small (≤3 cm) hepatocellular carcinoma |
| title_short | Surgery versus radiofrequency ablation in patients with Child- Pugh class-A/single small (≤3 cm) hepatocellular carcinoma |
| title_sort | surgery versus radiofrequency ablation in patients with child pugh class a single small ≤3 cm hepatocellular carcinoma |
| topic | hepatocellular carcinoma operation radiofrequency ablation survival |
| url | http://e-cmh.org/upload/pdf/cmh-2021-0294.pdf |
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